Posted by med_empowered on September 13, 2005, at 17:40:35
In reply to Re: Mom has to swich off Mellaril, whats closest ?, posted by linkadge on September 13, 2005, at 15:56:09
hi! What was her dosage of Mellaril? I think I might have read a post of yours in which you said she was on 100mgs or so (was that you? or someone else?) Anyway, if she's been low-dosing the Mellaril for a long time, she could probably do mid-range or full-dose atypical antipsychotic(s) with comparable effectiveness. As per usual, my vote would go for Abilify...its more or less weight neutral (some people who switch to Abilify off of lithium or zyprexa actually end up *losing* weight) and the EPS is pretty mild. Plus, it has hardcore D2 receptor occupancy; most atypicals have D2 occupancy rates around 70-80%, which is probably one reason they dont cause so much EPS. Abilify has a rate in the mid-80s-90s when dosed 10-30mgs daily...it just has a good side effect profile b/c it also acts as a dopamine agonist. Anyway, I guess my theory would be that, since Abilify acts more as a dopamine/serotonin regulator and modulator than a straight up anti-psychotic, it might be able to adjust the levels of dopamine/serotonin more selectively than other antipsychotics. It also seems to help with pre-existing tardive dyskinesia, so that could be a plus if that's an issue for your mother. As for older antipsychotics...maybe perphenazine? Its got some of the anti-anxiety effects of Mellaril, without the cardiovascular ill effects...if depression/anxiety is an issue, you could try Triavil (perphenaine+Elavil).
poster:med_empowered
thread:553834
URL: http://www.dr-bob.org/babble/20050909/msgs/554746.html